I scored 12 out of 15 on the quiz above. My main concerns are brain fog/poor memory, lack of interest in sex, 20-lb weight gain, craving salty foods & sweets, pain in the upper back and around my chest area, AND tired all the time! I have bags under my eyes that I can’t get rid of them. I also read where adrenal fatigue is associated with melasma…due to hormonal inbalance. I seen adrenal fatigue supplements that I could buy through Amazon. What do you recommend my next step be?
The term “adrenal fatigue” has been used to explain a group of symptoms that are said to occur in people who are under long-term mental, emotional, or physical stress. Supporters of adrenal fatigue say that you may be more likely to develop this condition if, for example, you have a stressful job; are a shift worker, working student, or single parent; or if you abuse alcohol or drugs.
Indeed, an article from a São Paulo university was released in 2016 with the title: “Adrenal fatigue does not exist: a systematic review.” According to this review, results of acceptable studies available to them at the time had “conflicting results” and could provide no definitive proof of the disease, nor diagnostic criteria or adrenal fatigue treatment. (4)
Can’t believe what I just read! ‘Adrenal insufficiency usually means there are long standing life problems’ and ‘because these side effects are not uncomfortable enough to be intolerable’ Is this a joke?! Adrenal insufficiency is a condition, usually autoimmune where the adrenal glands are destroyed. This is in no way because of any life problems! The symptoms of adrenal insufficiency aka Addison’s disease are so severe they greatly alter life and can be life threatening. A person with Addison’s disease needs medicine or they will die from this condition. They are also at risk of an adrenal crisis, this is life threatening and can be brought on by illness or extreme stress. If your adrenal glands are not working properly trust me you will know about it and an ACTH test will clinically prove low levels of cortisol. Please remind me of the tests for adrenal fatigue? Oh that’s right there aren’t any. Just pick a few symptoms out of the 75 listed, many of which contradict themselves greatly. Make sure to ignore any medical tests which have shown you to be in range and just like that you have adrenal fatigue – a condition which has no medical standing, no scientific evidence and was made up by a chiropractor! Let me do you all a favour – none of you have adrenal fatigue. This is a fact
BOTH Dr. Lam and Dr. Wilson have discovered the hypoglycemia - adrenal fatigue link, and they both offer an extended-release vitamin C as part of their supplement regimens, which is a critical component of adrenal fatigue. The blood sugar roller coaster of hypoglycemia is one of the prime reasons for adrenal-related fatigue and depression. These two doctors have made me aware of that. Dr. Lam also explores psychological aspects of adrenal fatigue syndrome, and advocates simplifying one's life as a part of recovery, as well as diet modification, reduction of chemicals, and other critical life modifications. Dr. Lam points out that stress reduction may include eliminating stressful relationships from your life (when possible).
A relatively new area of understanding, there are some who make the connection between adrenal fatigue and osteoporosis. It’s well-known that osteoporosis is often a result of imbalanced hormones. However, the sex hormones that are often named as the transgressors aren’t the only problem. Abnormally high or low cortisol levels are also associated with bone loss and osteoporosis risk. (36, 37, 38)

I’m in my early 20’s and have severe adrenal fatigue. It’s so bad that it has caused weight gain in the belly area, fluid retention everywhere, and severe hypoglycemia. I don’t understand how I have adrenal fatigue this bad when I’m so young. I’ve been on a third shift sleep schedule for about 6 years (going to bed anywhere from 3am-6am) but despite doing that, I sleep in late so I still get plenty of sleep. But I know people who have worked third shift for decades. So I’m assuming it couldn’t have caused severe adrenal fatigue after just 6 years, especially considering I’m still getting plenty of sleep? I’m guessing there are other factors at play here?
Carbohydrates: While carbohydrates aren’t all bad for you, the inflammation they can cause is particularly problematic when experiencing adrenal fatigue. Many people crave carb-heavy foods when they’re stressed, which offer a momentary satisfaction but end up taxing the adrenal glands more. If you’re overwhelmed and stressed out, try kicking the gluten and starchy carbs for a period of time to see if that may regulate your tiredness and energy levels.
I have Hashimoto’s and adrenal fatigue. I don’t know what’s causing my adrenal fatigue or how to find that out. Is it the autoimmune attack? Gut infections? Food sensitivities? The fact that I’ve been to like 50 doctors and nobody can help and they make me so stressed I want to yell at them? I also go to bed really late like 4am. And my blood sugar is chronically low despite eating protein and fat with each meal so I have these awful blood sugar swings which I’m sure is hard on the adrenals. I just don’t know how to figure out the cause and reverse it. Can you reverse it without figuring out the cause by taking a B complex and Vitamin C?

Ideally, cortisol is released into the system only on an occasional basis, rather than in response to chronic stress. If cortisol levels become too high for too long, they may have undesirable side effects, including loss of bone density, muscle wasting, thinning of the skin, decreased ability to build protein, kidney damage, fluid retention, spiking blood sugar levels, weight gain, and increased vulnerability to bacteria, viruses, fungi, yeasts, allergies, parasites, and even cancer.
You might wonder what the point of a thyroid test is, when we are looking to diagnose Adrenal Fatigue? The complexity of the human body means that one part of the endocrine system (the HPA axis) cannot exist independently of another part (the thyroid). In reality, there are connections and relationships that exist between every system in the body, and a weakness in one area can easily translate into changes in another.
Congenital Weak adrenals. Many children today are born with weak adrenals due to their parents’ nutritional deficiencies. This is not a genetic problem. Instead, it is due to the nutritional imbalances of the mother, in particular. These are passed through the placenta to the unborn child. For example, if the mother is zinc-deficient, as most are, the baby is born low in zinc and often high in copper, cadmium or other minerals that substitute for zinc to a degree. Fortunately, this means the problem can be corrected, though it is better to prevent it, of course. By age three or four, these children are in burnout. They are often sick, depressed and have difficulty in school. Some of these children react to the situation by becoming hyperactive, compulsive, obsessive or by developing various other behavior problems. On their hair mineral analyses, these children are often in a state of burnout at this early age, a relatively new phenomenon, in my experience. By gently rebuilding their body chemistry, however, their behavioral and other disorders generally vanish in a few months to a few years.
A part of the adrenal glands named the cortex is responsible for producing aldosterone, a mineralocorticoid which works with the kidney to regulate our fluid and mineral excretion. When the adrenals become fatigued, we produce less aldosterone and tend to excrete large amounts of important minerals in our urine. Individuals with depleted endocrine systems often report frequent urination, which is often attributed to age but may actually be caused by depleted adrenals.
And to make things even MORE complicated “Experts” say that when you crave Salt, that is a sign of Low Aldosterone, but then others say that the Swelling before the Period is not just low Progesterone, but High Aldosterone as well, so how can i have “High Aldosterone” in the final stages of Adrenal Fatigue..i say Final because the Panic attacks, Heart Palps and Insomnia are over, i am just having Low Blood Sugar sometimes and Salt Cravings always. IS it possible to have alternating Aldosterone levels EVEN in AF?
Adrenal hypofunction indicates an insufficient amount of cortisol and adrenal activity, exactly the opposite of adrenal hyperfunction. in adrenal hypofunction there is an excess in the amount of mineralcorticoids in the blood. This causes an increase in the amount of potassium in the cells and blood, and a decrease in the amount of sodium in the blood. Adrenal hypofunction, sometimes referred to as adrenal burnout, can result in chronic fatigue, exhaustion after exercise, abnormal fluid dynamics, low blood pressure and hypothyroid function.
If you have tiredness, brain fog, lack of motivation, among other symptoms, you should first have a thorough evaluation with a medical doctor. Anemia, sleep apnea, autoimmune diseases, infections, other hormonal impairments, mental illnesses, heart and lung problems, and kidney and liver diseases are just some among many medical conditions that could cause similar symptoms. If the workup from your medical professional turns out normal and you believe you might have adrenal fatigue, I would recommend you consider a fundamental question: Why would your adrenals be drained? Take a better look at what types of stress might be affecting you. For many, the hectic pace of modern life is to blame.
This one is still hard for me – I don’t want to disappoint anybody and there is always more work to be done. But managing stress means creating space in your life to refuel, spend time with the people you love, and doing what you need to do for you and you alone. Don’t just pencil it in. It’s as important as anything else you do for your health, and maybe more so.
I am 29 years old and I have had Gastric Bypass Surgery. I have lost 150 lbs since 2013. I have a lot of they symptoms that are described. I have a hard time getting out of bed, mild depression, brain fog, I get lightheaded when I stand up daily. I do drink a lot of caffeine about 2 energy drinks a day for the past 2 1/2 years. I fee like it is the only thing that can give me the energy to function. lately my blood sugar has been all over the place and I feel like I constantly have to snack in order to maintain feeling normal. I am on a Thyroid medication and my Thyroid is normal with that. My periods have been really off lately, I went to my Gyno who just put me on birth control. I want to see about going to an internal medicine doctor who can help me. because I don’t know what to do to feel better.
The adrenal glands, which sit on top of the kidneys, support us through stressful events. They secrete hormones that make us resilient in times of difficulty, like a sleepless night, illness, surgery, stress at work, stress at home, loss of a loved one, meltdowns at the store with toddlers, financial pressure, etc. The challenges – whether they’re short-term, long-term, severe or relatively mild – can sometimes overwhelm the adrenals. Because the effects of stress on the adrenals are cumulative, multiple sources of stress tend to compound the problem.
BOTH Dr. Lam and Dr. Wilson have discovered the hypoglycemia - adrenal fatigue link, and they both offer an extended-release vitamin C as part of their supplement regimens, which is a critical component of adrenal fatigue. The blood sugar roller coaster of hypoglycemia is one of the prime reasons for adrenal-related fatigue and depression. These two doctors have made me aware of that. Dr. Lam also explores psychological aspects of adrenal fatigue syndrome, and advocates simplifying one's life as a part of recovery, as well as diet modification, reduction of chemicals, and other critical life modifications. Dr. Lam points out that stress reduction may include eliminating stressful relationships from your life (when possible).
I didn't find any other book that explained what I was experiencing so spot on. I think Dr. Lam truly understands the deep levels and complexity of Adrenal Fatigue. HOWEVER, I think there is another business agenda going on here. His book also has a pervasive theme of "You won't get better without my help" when he states over and over: "it is needed to find a good practitioner experienced in natural healing in your area to guide you through this step"...it both validated me and increased my anxiety to read the book because I felt like unless I paid the enormous fee per phone call to get his help I wouldn't get better.
Thank you for the wealth of knowledge you share in your blogs and follow-up comments. What stage of adrenal/HPA-axis dysregulation would you consider a patient with the following results? Symptoms are consistent with abnormal cortisol levels and hypothyroidism; current treatment protocol from primary includes Armour thyroid 30mg. Could Hashimoto’s (or autoimmunity) be a possible cause? Or are lifestyle factors (sleep, glucose regulation and diet, stress, etc.) more likely for the following patterns?
Dr. Wilson also delves into the types of people and personalities who are commonly afflicted with this syndrome. He explains how different professions can leave certain people vulnerable to the type of stress that can overload their adrenals and result in this syndrome. Included also are examinations of how certain diseases have an adrenal component that can lead to adrenal exhaustion.

It is ordinary for stress to cause cortisol levels to rise in a normal fashion, but in adrenal fatigue the output of cortisol and other adrenal hormones is constantly being stimulated. This overstimulation causes the body’s vitality to dwindle. With each downshift in adrenal function, the body is considerably more affected in a negative fashion: “adrenal fatigue, in all its mild and severe forms, is usually caused by some form of stress…. It is important to know that your adrenals respond to every kind of stress the same, whatever the source” (p 11). Cortisol is a powerful hormone that has a profound effect on every organ and system in the body.
If you truly have adrenal fatigue syndrome your most definitely going to suffering from some other obvious condition as well. Failure of the adrenal glands To work properly would cause serious side effects in your body that you would notice far sooner then you would notice this so called syndrome. All the symptoms mentioned above can signify multiple different illnesses that are more likely for you to have then an adrenal problem, such as depression for instance or just being tired. Adrenal fatigue syndrome is a fad illness, if you go to any doctor saying you think you have it they will laugh at you. I’ve seen it happen. Try taking a nap and taking care of yourself.
One of the most commonly overlooked causes of Adrenal Fatigue is intestinal infections that gives rise to an inflammatory response. Such infection can occur sub-clinically with no obvious signs at all. Infections in the gut, including giardia, SIBO (small intestinal bacterial overgrowth), fungal dysbiosis, and h. pylori infection are just a few that may contribute to adrenal dysfunction.
Insulin-Induced Hypoglycemia Test: The insulin-induced hypoglycemia test is used to determine how the hypothalamus, pituitary and adrenal glands respond to stress. During this test, blood is drawn to measure the blood glucose and cortisol levels, followed by an injection of fast-acting insulin. Blood glucose and cortisol levels are measured again 30, 45 and 90 minutes after the insulin injection. The normal response is for blood glucose levels to fall (this represents the stress) and cortisol levels to rise.
To our knowledge, this is the first systematic review made by endocrinologists to examine a possible correlation between the HPA axis and a purported “adrenal fatigue” and other conditions associated with fatigue, exhaustion or burnout. So far, there is no proof or demonstration of the existence of “AF”. While a significant number of the reported studies showed differences between the healthy and fatigued groups, important methodological issues and confounding factors were apparent. Two concluding remarks emerge from this systematic review: (1) the results of previous studies were contradictory using all the methods for assessing fatigue and the HPA axis, and (2) the most appropriate methods to assess the HPA axis were not used to evaluate fatigue. Therefore, “AF” requires further investigation by those who claim for its existence.
I had a horrifically stressful past two years with job changes and a death in the family and identified with the symptoms described above and more. After seeing regular doctors and a psychiatrist, I finally found a naturopath doctor who had me thoroughly tested. My DHEA-S level was below normal range and the 4x/day saliva test showed my cortisol level dropping over 90% from the mid-range of normal in the morning to the very bottom of the range by noon and lower the rest of the day. She called the pattern “flat lining.” So this is clearly not normal, but it’s also not a “recognized condition”? I’ve been taking two thyroid medications for nearly 30 years – including Armour Thyroid, which most doctors don’t know how to prescribe – and have now added an adrenal supplement. Once we got the right dosage I started to feel better within a few days. I can finally sleep and have more energy throughout the day. I don’t care if you think adrenal fatigue doesn’t exist. I am proof that it does, and that it can be treated.
Cortisol increases your appetite and energy level while toning down your immune system’s allergic and inflammatory responses. This hormone stimulates the storage and release of energy in the body, helps the body resist the stressful effects of infections, trauma, and temperature extremes, and helps you maintain stable emotions. Synthetic versions of cortisol — prednisone and cortisone, for example — are often prescribed to help people perk up and feel better so they will eat, drink, and move around more and therefore be better able to fight off illness or heal from an injury.

I just took dr Wilson’s test and scored in the “severe” range. Not really news to me… I’ve been depressed and burnt out for a whole now, although I find it interesting that there may be a physical reason why I’m feeling this way. Not sure what to really do about it though, since I’m already doing a lot of the things to “be kind”. What do I do now? Do you have a link to other posts that talk about how you recovered?

Hi heather, thank you for all the time and energy you put into your blog. I always enjoy your posts while nursing my little ones to bed. I never leave a comment on anything but this time I had to. We had a very stressful move during my fourth pregnancy and I felt like a different person after that. A friend of mine gave me dr. Wilson’s book and his advice along with taking vitamin c, magnesium, and his own supplement, Adrenal Rebuilder, restored me. It was a very difficult time for me and I am so grateful for that book. I hope get the rest you need but I know how hard it is when your children are young.
As the manufacturer of adrenaline, they are the “glands of stress,” but are also the first glands to fail during prolonged or intense periods of stress. The problem with stressors is that they are “cumulative,” in the sense that their impact tends to add up in the body over time until your adrenal glands just can’t take anymore. Adrenal “fatigue” or dysfunction used to be rare, but is now all too common because of our lack of relaxation and other lifestyle factors, such as smoking, sleep deprivation, poor eating habits and excessive caffeine intake, as well as exposure to environmental toxins and allergens.
To assess adrenal function, we conduct a one-hour ACTH stimulation test, which is very safe and reliable. We also look for thyroid issues and diabetes. After checking for a variety of endocrine disorders using testing and symptom assessment, we start working with a multidisciplinary team of doctors to figure out the root cause of the patient’s problem.

I recently ordered a hormone test kit from John Lee's website, in an effort to figure out some health issues I was having. I included cortisol levels in the kit, because I am a type-A person and figured my cortisol levels were high and perhaps that contributed to the issues. Surprisingly, my cortisol levels were low at all 4 times of the day tested. A good doctor I showed the results to said "You have adrenal fatigue" and recommended an adaptogen called Adreno-Mend. As a retired RN, I felt a bit stupid and in an attempt to educate myself I ordered this book. I had no frame of reference for adrenal fatigue and this book provides an excellent explanation, as well as a framework to overcome the life style choices that have contributed to your adrenal fatigue. The endocrine system is so complicated, I don't pretend to understand it all, but rest assured, if one thing is out off order, it affects all your other hormones so they cannot function optimally. That includes all your glands regulating metabolism, digestion, immunity, quality of sleep, etc. I'm sure in our busy culture there are millions of people who suffer needlessly because they are unaware and they have a doctor who is not tuned in to all this. I had enough insight to order the test kit, maybe because I'm a nurse, maybe God steered me there. Once I had the results, I made an appointment with my family doctor (who I like a lot), to discuss it with him. He looked at the report and said "This is not mainstream medicine; you don't need hormone replacement; this is a natural part of aging." So, even if you go to a board certified internist who you like, you can't depend on them to be enlightened and pro-active on your behalf. Cortisol is a hormone that regulates many aspects of our health and/or illness so it is beyond me how it is not "mainstream medicine"; this author even states that many people who come to physicians with these symptoms of stress, anxiety, inability to sleep, etc, are given anti-depressants or sleeping pills or told to seek pyschiatric care. He makes the point: You are not crazy, there is a physical cause for what is happening and you can have understanding and some control over your symptoms.


First, remember that any new dietary regimen or addition of supplements in your lifestyle should be implemented under the supervision of a physician/naturopath you trust. In general, introducing more plant-based foods into your lifestyle and eliminating stimulants, sugary foods and processed items with a ton of sodium or chemicals added to them is going to help you feel and live better, regardless of conditions you may or may not have.
Scientists in China have designed a cohort study to examine the interaction of genetics, biomarkers and environmental exposures with health metrics lead to chronic diseases. A validated questionnaire, along with a large battery of tests, has led them to develop a classification referred to as “suboptimal health.” This phase is essentially a step between optimal health and diagnosable illness or disease characterized by “the perception of health complaints, general weakness, chronic fatigue and low energy levels.”
Adrenal fatigue is characterized by relentless, debilitating fatigue. The adrenal glands are your body’s primary “shock absorbers.” These two little thumb-sized glands sitting on top of your kidneys produce hormones including norepinephrine, cortisol and DHEA that allow you to respond to the conditions of your daily life in healthy and flexible ways.
The first question to ask is what stage the individual has reached. If he or she is still on Stage 1 or 2 Adrenal Fatigue, where cortisol levels are still high, then a recovery may take very little time. If the condition is caused by temporary stress at work or bereavement, we can reasonably expect cortisol levels to return to normal once the stress has passed. In fact, many of us enter Stage 1 or 2 Adrenal Fatigue multiple times during our lives, only to pass out of it within a few months as the underlying cause disappears.

Hi Dr. Jill – I have a theory that i would love to get your opinion on? I believe that i have adrenal fatigue and also urinary retention. I have puffy eyes, especially on the bottom. I have Hashimotos any many other issues. I am trying to figure out the cause of the urinary retention and have noticed that when i get hyped up, such as when rushing for an important occasion, such as a wedding , funeral or such that i have a great release of my bladder when i am rushing to get ready for the occasion. I am wondering if it is the adrenal fatigue that is causing the retention and then when i am rushing around and using up my reserve energy , that is when my bladder releases the urine. Any input would be much appreciated, thank you!


While adrenal fatigue may not exist, this doesn’t mean the symptoms people experience aren’t real. These same symptoms could be caused by true medical conditions such as sleep apnea, adrenal insufficiency, or depression. Accepting a fake disease diagnosis from an unqualified practitioner is arguably worse. Patients don’t receive a science-based evaluation of their symptoms, and they may be sold unnecessary treatments that are probably ineffective and potentially harmful. The Endocrine Society’s guidance is entirely appropriate:


You may still order items that are on backorder and labeled “temporarily out of stock.” These items will ship as soon as they are available. If the items are not available after 21 days, we will cancel your backordered items. Your credit card will not be charged for the canceled items. Should this occur, you will receive a cancellation notice email.
Unlike other endocrine disorders that are caused by physical damage to parts of the adrenal glands, hypoadrenia is seen by many in the natural health world as a “middle ground” syndrome with simple and easy-to-implement solutions. Currently, no official diagnosis exists for adrenal fatigue and people are either considered to have normal endocrine function or total endocrine failure, like that seen in Cushing’s syndrome or adrenal insufficiency/Addison’s disease. Some postulate that this occurred in the 1950s when doctors over-prescribed adrenal steroids and saw dire consequences, leading to an overcorrection and generalization of endocrine issues. (2)

We now know that HPA axis dysfunction is a more appropriate description of the fatigue that comes with adrenal dysfunction. Shift work has long been associated with increased health risks, including risk of insulin resistance, weight gain, cardiovascular disease and brain dysfunction. Many people do not have a choice but it is not a good idea to consistently lose sleep or upset your body’s circadian rhythm.

Dr. Wilson created adrenalfatigue.org specifically to help you and the many others experiencing this very common problem caused by too much stress. Take the Adrenal Fatigue Questionnaire to see if low adrenal function may be your problem. Learn more about adrenal fatigue and how stress and adrenal function can affect your health and other related health conditions. Follow the guidelines for adrenal recovery Dr. Wilson developed over decades of clinical practice and research. Find a health professional familiar with adrenal fatigue to help you. Best of all, discover that you can reclaim your vitality and thrive in a stressful world!
This treatment plan comes in several downloadable ebooks (in PDF format), audio files, and a video course. Please note that no physical product will be shipped to you. It is fully compatible with PCs, Macs, iPads, Android tablets and many other computers and mobile devices. If you have any problems downloading the treatment plan, just contact us here and we will be happy to help you.

Another oft-quoted piece of evidence against the existence of adrenal fatigue is Todd B. Nippoldt’s interview with Mayo Clinic, stating essentially the same concerns. (6) Again, it is stated that consistent levels of chronic stress have no effect whatsoever on the adrenals and the only true endocrine disorders are those caused by other diseases and direct damage to the adrenal glands.
Pick begins by covering a number of important topics: the nature of adrenal dysfunction, the effects of chronic stress, and how you can identify your own “adrenal profile.” From there she moves on to solutions that encompass a thirty-day period of concerted recovery efforts. That plan includes dietary changes, supplement advice, exercise, and a focus on the emotions that is often lacking in other books. There’s even a complete 30-day eating plan with recipe ideas. The book then addresses life after recovery, and attaches a number of reference guides, resources, and an index at the end.
I find it curious that suboptimal health status (SHS) has many of the same tenets as what we refer to as adrenal fatigue. Actually, people classified as having SHS have “significantly higher levels of plasma cortisol,” and confirm the correlation between stress and suboptimal health. This has led those studying SHS to realize that reducing the stress in work environments may help to prevent chronic diseases in the future. (16)
Here’s another important thing to know about cortisol testing. Taking a single measurement, or even a 24-hour average, is not enough. The best cortisol tests take 4 individual samples at various points of the day and then map your cortisol levels over the course of a 24 hour cycle. Our cortisol levels vary dramatically, starting high when we wake up and then tapering off until they reach their lowest point late at night. This usually represents something like an 80% drop, which is perfectly normal. Your health care professional needs to see not just your average cortisol level, but also the size of the morning spike and how sharply it drops off afterwards.
What's to know about pheochromocytoma? Pheochromocytoma is a rare, potentially life-threatening tumor of the gland in the body that produces adrenalin. In this article, learn about the symptoms of pheochromocytoma and their potential complications, as well as the function and anatomy of the adrenal gland. Read on to find out about outlook with the tumor. Read now
×